Community-level educational attainment and dementia: a 6-year longitudinal multilevel study in Japan.
Community-level educational attainment and dementia: a 6-year longitudinal multilevel study in Japan.
复制标题
DOI：
10.1186/s12877-021-02615-x
复制
发表时间：
2021-11-23
期刊：
影响因子：
4.1
通讯作者：
Kondo K
中科院分区：
文献类型：
--
作者：
Takasugi T;Tsuji T;Hanazato M;Miyaguni Y;Ojima T;Kondo K
由于对社区教育水平与痴呆症之间关系的认识不足，本研究探讨了社区低教育程度患病率与痴呆症发病风险的关联。通过这项研究，我们进一步探讨了城市和非城市地区上述协会的潜在差异。我们分析了日本老年学评估研究的6年前瞻性队列数据，从2010年至2012年收集的基线数据开始，包括来自7个县16个市的346个社区的51，186名身体和认知独立的年龄≥65岁的人（23，785名男性和27，401名女性）。我们使用日本长期护理保险系统的可用数据评估痴呆症发病率。我们将受教育年限分为≤9年和≥ 10年，并将个人水平的教育程度作为社区水平的自变量进行汇总。模型1协变量为年龄和性别。模型2中增加了收入、居住年限、疾病、酒精、吸烟、社会隔离和人口密度。我们进行了多重插补以解决缺失数据。我们进行了两个水平（社区和个体）的生存分析，以计算风险比（HR）和95%置信区间（CI）。结果表明，随访期间痴呆的累积发病率为10.6%。受教育程度≤9年的平均比例为40.8%（范围：5.1-87.3%）。低社区水平的教育程度与较高的痴呆症发病率显著相关（HR：1.04; 95%CI：1.01-1.07），在调整个人水平的教育年和协变量后，估计低教育程度的10个百分点。虽然这种关联在非城市地区很显著（HR：1.07; 1.02-1.13），但在城市地区没有关联（HR：1.03; 0.99-1.06）。在调整个人水平的教育程度和协变量后，生活在其年龄人口中教育程度低的社区的老年人比生活在教育程度高的地区的老年人更容易患痴呆症;这种关联在非城市地区很明显。因此，将青少年教育作为一个生命过程和人口办法，对于预防生活在非城市地区的老年人晚年患痴呆症至关重要。在线版本包含补充材料，可通过10.1186/s12877-021-02615-x获得。
As the understanding of the association between community-level education and dementia is insufficient, this study examined the contextual association of community-level prevalence of low educational attainment on the risk of dementia incidence. With this study, we further explored the potential differences in the aforementioned associations for urban and non-urban areas. We analyzed 6 years of prospective cohort data from the Japan Gerontological Evaluation Study, beginning with the baseline data collected between 2010 and 2012, for 51,186 physically and cognitively independent individuals aged ≥65 years (23,785 men and 27,401 women) from 346 communities in 16 municipalities across 7 prefectures. We assessed dementia incidence using available data from the long-term care insurance system in Japan. We dichotomized education years as ≤9 and ≥ 10 years and aggregated individual-level educational attainment as a community-level independent variable. Model 1 covariates were age and sex. Income, residential years, disease, alcohol, smoking, social isolation, and population density were added in Model 2. We conducted multiple imputation to address the missing data. We performed a two-level (community and individual) survival analysis to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). The results indicate that the cumulative incidence of dementia during the follow-up period was 10.6%. The mean proportion with educational attainment of ≤9 years was 40.8% (range: 5.1–87.3%). Low community-level educational attainment was significantly associated with higher dementia incidence (HR: 1.04; 95% CI: 1.01–1.07), estimated by 10 percentage points of low educational attainment after adjusting for individual-level educational years and covariates. While the association was significant in non-urban areas (HR: 1.07; 1.02–1.13), there was no association in urban areas (HR: 1.03; 0.99–1.06). Older people living in communities with low educational attainment among their age demographic develop dementia more often compared with those living in areas with high educational attainment after adjusting for individual-level educational attainment and covariates; the association was pronounced in non-urban areas. Securing education for adolescents as a life course and population approach could thus be crucial in preventing dementia later in life among older people living in non-urban areas. The online version contains supplementary material available at 10.1186/s12877-021-02615-x.
登录
查看更多内容
影响因子：
4.4
作者：
Basta, Nicole E.;Matthews, Fiona E.;Brayne, Carol
通讯作者：
Brayne, Carol
影响因子：
2.8
作者：
Saenz JL;Downer B;Garcia MA;Wong R
通讯作者：
Wong R
影响因子：
4.7
作者：
Kondo K
通讯作者：
Kondo K
影响因子：
7.7
作者：
Russ, Tom C.;Batty, G. David;Starr, John M.
通讯作者：
Starr, John M.
影响因子：
168.9
作者：
Tamiya, Nanako;Noguchi, Haruko;Campbell, John Creighton
通讯作者：
Campbell, John Creighton